Friday, January 25, 2008

NICE Report on Physical Exercise

NICE (which stands for National Institute for Health and Clinical Excellence) has just released a new UK guidance report entitled "Physical Activity and Environment: Guidance".

The report highlights the harms of our inactivity and the complex challenges we face in trying to promote physical activity. Here is a sample:

Physical activity not only contributes to wellbeing, it is essential for good health (DH 2004). Increasing physical activity levels in the population will help prevent or manage over 20 conditions and diseases. This includes coronary heart disease, diabetes, some cancers and obesity. It can help to improve mental health. It can also help older people to maintain independent lives.

In 2004, the DH estimated that physical inactivity in England cost £8.2 billion annually (this included the rising cost of treating chronic diseases such as coronary heart disease and diabetes). It is estimated that a further £2.5 billion each year is spent on dealing with the consequences of obesity. Again, this can be caused, in part, by a lack of physical activity (DH 2004).

Physical activity levels vary according to age, gender, disability, ethnicity and socioeconomic status. (National data on physical activity are not broken down by faith, religious belief or sexual orientation.)

Facts and figures

Adults are recommended to undertake a minimum of 30 minutes of at least moderate-intensity activity on most days of the week (DH 2004). Around 65% of men and 76% of women in England do not achieve this (Joint Health Surveys Unit 2004). Seventy per cent of boys and 61% of girls aged 2–15 years are sufficiently active to meet the recommendations for their age (at least 60 minutes of at least moderate-intensity activity each day). Trends between health surveys for England in 1997, 1998, 2003 and 2004 found small increases in physical activity levels between 1997 and 2004. Between 1999 and 2004 (when the same physical activity questions were included for each survey) there were significant increases in the percentage of adults meeting the national recommendations. However, changes in the way physical activity is measured over time mean that no clear trends can be determined (Stamatakis et al. 2007).

Data from the ‘National travel survey’ show that the distance people walk and cycle has declined significantly in the last 3 decades (Department for Transport 2007a). The average distance walked, per person per year, has fallen from 255 miles in 1975/76 to 201 miles in 2006. Bicycle mileage for the same years fell from 51 to 39 miles per person per year. However, some of the surveys may not have captured all walking and cycling trips.

Environmental issues

Increasing levels of physical activity is a challenge, not just for those directly involved in public health but for professionals, groups and individuals in many sectors of society. Adults, young people and children can achieve the national recommended levels by including activities such as walking, cycling or climbing stairs as part of their everyday life. However, while individual interventions to promote such activity may be important, they are not the only (nor possibly the main) solution. Other issues, including environmental factors, need to be tackled. As Schmid and colleagues say (1995), ‘It is unreasonable to expect people to change their behaviours when the environment discourages such changes’.